Medical abortion in early first trimester Is the hospital stay necessary?

Purpose: To investigate the possibility of pregnancy termination based on medical administration without hospital stay.

Patients and methods: During the period from April 2007 to December 2015, 75 women with pregnancy until 49 days after LMP (last menstrual period) underwent medical termination by using 600 mg mifepristone (RU 486) per os and 48 hours later 800 µg misoprostol (cytotec) vaginaly. All participants were consistent with surgical abortion if deemed necessary and a transvaginal ultrasound was performed to confirm an intrauterine pregnancy before the medical administration. The indications for the abortion were as following: missed abortion, embryonic demise, spontaneous and induced abortions.

Surgical intervention was indicated because of failure of the medical induced abortion, excessive bleeding, persistent products of conception 5 weeks later, or other serious medical conditions.

Results: According to our study, RU-486 administration led to complete abortion in 78.6% of pregnancies within 48 hours without the need of administration of misoprostol, confirmed by ultrasound examination. 21.4% of pregnancies after the RU-486 administration led to incomplete abortion within 48 hours and cytotec was administrated vaginaly. None case underwent surgical abortion. Side effects like nausea, vomiting, pain, moderate bleeding occurred but were acceptable and hospital stay was not noticed.

Conclusion: The combination of RU-486 and cytotec and the single administration of RU-486 are safe and effective for medical termination of pregnancy in early first trimester. However, a larger sample is required to be assessed so as to confirm the effect of the combined administration on the complete abortion rate.